Renal dysfunction is a common and serious problem in patients with advanced liver disease. In particular, alterations in renal physiology in acute liver failure or cirrhosis with ascites can predispose patients to a specific functional form of renal failure known as hepatorenal syndrome

The accurate assessment of the kidney function and injury is currently affected by the reliance on the measured concentration of serum creatinine,which is significantly affected by the degree of cirrhosis, hyperbilirubinemia and the nutritional state of the patient.

■ Obesity and metabolic syndrome are also strongly associated with the development of hypertension and diabetes

■ Hepatitis C has long been associated with several glomerulopathies

Viral RNA, proteins and particles have been isolated from kidney biopsy specimen, hepatitis C infection has been reported to be associated with focal segmental glomerulosclerosis. Hepatitis C also has been associated with an increased risk of albuminuria, progression of diabetic nephropathy and progression of kidney disease.